I consider it best to reserve
the name Tuberculinum for this preparation of Koch, as
it is universally known by that name. Burnett's "Bacillinum"
is now accepted as the name of the original homœopathic preparation, and though its
originator, Swan, named it Tuberculinum, it owes its
present position in therapeutics to Burnett, and it will simplify matters if we make the
term Bacillinum cover the homœopathic nosode and Tuberculinum the preparation of Koch. When Koch's Tuberculinum was first launched the medical papers were teeming
with reports of cases undergoing the injection for various diseases. Of the reported
effects, curative and pathogenetic, I made a collection. These will be found in H. W., xxvi. 155. I have there given the authority for the
observations and the nature of the cases in which the effects were observed. These symptoms
will be found arranged in the Schema, and each symptom has appended to it the initial of the
observer, or an indication of the disease from which the patient was suffering when the
observation was made. Koch's own observations are marked (K); Virchow's, (V); Jonathan
Hutchinson's, (H); Ewald's, (E); Albrand's, (A); Watson Cheyne's, (W C); Lennox Brown's, (L
B). The names of other observers are given in full. Lupus cases are marked (lps.);
observations made on a leper (lpr.). In Jour. Belge d'H.,
1894, 236, Mersch published a pathogenesis of Tub.
compiled mainly from the same sources as mine, but giving some additional symptoms. These I
have included and marked (M). A few cured symptoms are put in brackets. The undistinguished
symptoms are from a proving by Nebel, of Montreux (H. W.,
xxxv. 397). The provers were tuberculous individuals, mostly workpeople, and only
pathogenetic symptoms are recorded. Tub. 30 was used,
the preparation having been obtained from Hausmann's Pharmacy, St. Gall. I do not find any
appreciable difference between the action of Tub. and
that of Bac. My own impression is that they are
practically identical, and that the one will answer to the indications of the other. Nebel
has used Tub. in exactly the same way as Burnett and
others have used Bac., on the indications Burnett laid
down and with Burnett's results. In H. W. for May, June,
and July, 1901, I have copied from H. R. of the same
year articles by Nebel giving his experiences with Tub.: (1)
Boy, 13, had diphtheria with fearful headache extending from neck to vertex, with swelling
in back of neck and occiput, due, it was supposed, to an affection of the middle ear. Seven
weeks passed without improvement. Paracentesis of the tympanum resulted in the evacuation of
pus for a day or two. Nebel found the face bloated; strawberry tongue coated white at the
root; mastoids not sensitive to even strong pressure. Swelling of occiput and neck down to
fifth dorsal vertebra. The head is held fixed sideways towards the middle of the clavicle.
If the boy wants to move his head he has to seize it with both hands and turn it slowly,
with painful distortion of facial muscles, until it reaches the position desired. Even the
slightest pressure on first, second, or third cervical vertebra was very painful; the skin
on them was reddened and the periosteum was swollen; glands in neck enlarged. Tuberculosis
of atlas and second and third vertebræ consequent on diphtheria was diagnosed. Tub. 1m. was given, five grains, during the day. Two days after
the dose the boy could move his head more freely, the swelling of the neck diminished,
appetite returned, and in a short time he was able to get up and run about. Five weeks after
the dose, the swelling had altogether gone, and the boy's condition was altogether changed.
(2) Swelling of tibiæ two inches below the knee, in a
lady who had had cough for twenty years. Cured chiefly with Tub.
1m. This patient had offensive sweat in axillæ, strawberry tongue, lack of appetite.
Distaste for milk, constipation, and bad sleep. [Mau, of Kiel, treated the following cases
with Bac. (H. W., xxxvi. 316)─I
introduce them here for comparison: (1) Vigorous man,
tall and of well-developed appearance, was very liable to get pneumonia in cold weather, and
spent the winter in some sanatorium or other in order to escape. His father had died of
pneumonia, his mother of consumption, and a sister was consumptive. He perspired much, took
much fluid nourishment, partly alcoholic. Sleep poor. Almost constant fever. Enlarged
glands. Three months' treatment with Bac. removed all
the symptoms, and, moreover, made his tissues less watery and reduced his corpulence
somewhat. (2) A distinguished author, 50, complained of
dreadful pains in the head, almost total insomnia, and great debility. His brother and
sisters had mostly died of dropsy of the brain; he himself had congestion of the right lung,
due probably to healed cavities, as he has frequently had hæmorrhages. For this he had had
a lengthened treatment in the South, and had been pronounced cured of consumption. Softening
of the brain and loss of reason were now feared. The headache was attended with a sensation
as if his head was being tightly squeezed behind with an iron ring. Hands trembling; but he,
was most uneasy from a sensation in, his back as if his clothes were moist. In less than a
month, under Bac., the headache, insomnia, and sensation
in the back had all vanished. Another patient of Mau's, a child, had "screaming out in
sleep and great restlessness at night," which were cured, along with peevish,
irritable, taciturn disposition.] In 1892 B. S. Arnulphy (Clinique,
xvi. 629) began giving Tub. 6x. and 8x trituration
internally in tubercular cases, acute and chronic, and with
encouraging success, but with at times undesired aggravations; with 12x and 30x
these were avoided. In one case, originating in grippe, both apices were affected, the right
one breaking down; and abundant pleuritic effusion on the left side. Six weeks' treatment
with Tub. brought about recovery, and seen a year later
the patient was quite well except for retraction of the left side. Arnulphy considers (Clinique, xvii. 86) that Tub.
is frequently the remedy for bronchitis, catarrhal pneumonia, lobular pneumonia, tubercular
pleurisy, parenchymatous nephritis, and grippe. He gives (Clinique,
xvii. 457) two cases of acute lobular pneumonia with characteristic symptoms and high
temperatures quickly resolved by Tub. One was in a boy
of three who received the 12x; the other was a man, 78, being a sufferer from chronic
bronchial catarrh. The latter was taken with grippe, pneumonia developed, and he was in a
very serious state. Tub. 30x made, an almost immediate
change for the better, and recovery followed. Arnulphy relates that in this cage an abundant
perspiration took place (the skin had been dry) during the night and he had observed this in
all cases of pneumonia when Tub. acted favourably. I
have found Tub. 30, loop 200, and 1m the best general
antidote to the chronic effects of influenza poisoning. B. G. Clark (H. W., xxix. 349) reports the case of a lady, 60, who had had for
some time a mild form of tuberculosis of the skin of the face, and, more recently a small
growth (lupus) on the side, of the nose on a line with the inner canthus of left eye. It had
grown much in six. mouths. Tub. 200 F. C., six powders
given, one to be dissolved in twelve teaspoonfuls of water, one teaspoonful every two hours.
The six powders were taken in this way on successive days. On the fifth day the growth began
to dry up. On the tenth it fell off. Another dose of Tub.
was given after this with marked improvement to the older affection of the face. A curious
use has been made of Tub. by Jauregg, of Vienna, in a
case of insanity (H. W., xxx. 196). Having observed that
cases of insanity are always benefited by an attack of an acute infectious disease,
especially if it is accompanied with high fever, the idea occurred to him of utilising the
fever produced by Koch's Tuberculin injections. He tried
it on some patients, and though the decidedly, favourable symptoms, soon disappeared after
the fever subsided, still there was a steady clearing of the
comfused sensorium. Insanity is very frequently a manifestation of the
consumptive taint and there is something more than a pyrexial power in Tub. [Burnett has cured with Bac.
a case of insanity, being led to give it by a ringworm-like eruption on the body.] Among the
Peculiar Sensations noted under Tub.
are: As if the brain were squeezed with an iron ring. As if the teeth were jammed together
and were too many for the mouth. Of mucus in the throat; of a tumour in the throat. Pressure
in stomach going to throat as if the clothes were too tight. As if the clothes on the back
were wet (Bac.). Fatigue, faintness, profuse debility
are frequent symptoms. Great weakness in the limbs after dinner: this at times amounts to
paralysis. The circulation is always disturbed, chills and flushes alternating.
"Shivering when beginning to sleep" is a peculiar and interesting symptom; also
"cold feet in bed," which is common in persons of low vital reaction.
"Sensitive to music" was observed in one of Nebel's patients; another had pains in
the region of the appendix vermiformis, which should lead to serviceable action in
appendicitis cases. The symptoms are: < By slightest
exertion (it = excessive fatigue; sweat). Walking = pains in loins (fatigue). Raising himself up = palpitation. Every movement =
sticking in chest and back. Rubbing = itching to change
place. < Morning (much purulent expectoration;
sickness and nausea; loss of appetite; thirst; fatigue). <
From 10 to 3 p.m. (frontal headache). < Evening (heat
in head; cough preventing sleep; severe pains in breast at beginning of menses. < Evening in bed (itching; feet cold). < Night (sweat; from 3 a.m. sleep disturbed). < Beginning to sleep (shivering). <
After dinner (flushing; drowsiness). Sensitive to music.
